Life With Type 2: When You Know More Than Your Doctor

I got the bad news about having type 2 one summer day in 2003 from my doctor, a very popular general practitioner with a large practice. He didn’t mince words: “You have diabetes.”

While he was certain about the diagnosis, he was vague about what steps I’d have to take to start dealing with the disease. There was the usual advice about exercising more, not consuming sugar, avoiding fat, and something about maybe crossing potatoes off my list of permissible edibles.
That was my first inkling that he wasn’t going to be any sort of a coach or advisor to me. He was a busy man who knew about many medical conditions, but not an expert or specialist in any of them. The “general practitioner” designation should have alerted me.

I ran out to buy books on type 2, and started checking out diabetes websites. I quickly noticed that while there was some general agreement about what diabetes is and does, there was no consensus about what causes it or if it could be reversed. When you read books like Reversing Diabetes and The 30-Day Diabetes Miracle, you begin to think that maybe you can pull a Rocky and deliver some decisive hammer blows to your disease.

Then you read, The First Year: Type 2 Diabetes, which assumes that there will be a second year of type 2, and a fifth, and a 10th, and a 20th. No grand pushback in the offing here, only a clever and extended rearguard fight against a progressive disease.

So my first big decision was to do the old “hope for the best and prepare for the worst.” Even as I believed I might someday reverse my diabetes, I also viewed all the steps I was taking to manage it as holding actions.

Along with doing much reading, I did some simple experimentation, which I’ve described here before – lots of finger-pricking to test fasting, post-exercise, post-meal, and late-night blood sugar levels. All of this to identify my individual pattern, and to address that in specific, not general, terms.

After a few months of dealing with type 2, I began to notice that my doctor couldn’t answer some of my questions, or didn’t know about the current research I brought to his attention. This alerted me to a responsibility that had not occurred to me before: It really was me who was in charge now of my disease. Unlike somebody with cancer or heart disease who needs the skills of a highly educated professional for treatment, a type 2 has the privilege of time and a lot of say in figuring out the best approach to his disease.

Some things I’ve learned along the way:

1. Doctors don’t know everything. Nor should they. They’re trained to run through a lot of possibilities on the way to diagnosing a condition. That doesn’t mean they know everything there is to know about that condition (unless they’re a specialist), any more than a taxi driver who knows how to get to any restaurant in town knows every restaurant’s menu.

(In the case of endocrinologists, who know a heckuva lot about diabetes, my expectations are higher. I’ve only dealt with one over the past decade, and I’ll say that the man knows his stuff. We’ve have some great discussions, and I’ve always come away feeling a little more enlightened.)

2. Don’t believe everything you read about diabetes. At least not right away. When I first started studying up on the disease, I realized that some very intelligent people had some vastly different takes on type 2. For example, the American Diabetes Association urges low-fat, moderate-carbohydrate diets, while an outlier like Dr. Richard K. Bernstein looks upon fat as friendly and carbs as foes. Who is right?

The best I could do was watch as scientists increasingly took up the study of fat versus carbs and wait for the evidence to start tilting the argument one way or the other. Now, 11 years after my official diagnosis, it appears that Dr. Bernstein was right all along. But it took patiently tracking the long debate before I could finally decide what to believe.

3. Understand that everybody who has something to say about diabetes has both an emotional and a monetary stake in it. (My monetary stake is modest, but I do get paid to write for Diabetes Health.) That isn’t to say I find anything wrong with having a financial stake in different issues. For instance, the Juvenile Diabetes Research Fund relies on contributions to finance a cure for type 1. Financial analyst David Kliff, the honest, plain-spoken publisher of Diabetes Investor, who minces no words when it comes to his opinion about various diabetes drugs or the market for them, relies on subscribers-a money flow-for part of his living.

Pharmaceutical companies invest millions to create new type 2 drugs, which means they have a direct stake in making back their costs. Bariatric surgeons, who have enjoyed demonstrably great results with type 2s who have undergone gastric bypass surgery, are justifiably strong advocates for their craft.

Whatever your opinion of these people and organizations, what they do is legal and straightforward. None of them claims to have a cure or to know the path that will lead to an eventual cure.

Not so the clever folks who advertise in Sunday papers with offers of a free meal in a hotel ballroom if you’ll just come on down and listen to a presentation on how to totally reverse your diabetes. The presentations, always made by a dynamic speaker who just happens to have a series of books, DVDs, and personal therapy sessions to offer, always come at a steep price if you decide to sign up. Fixing dinner for scores of people and renting a big room to hold them in is expensive. Somebody has to pay for it, namely, the people who get taken in by newspaper ads.

“Go figure.” That’s my standard-issue response to my sometimes dramatically fluctuating blood glucose levels, or my neighbor Paul’s amazingly good fasting levels in the morning despite having had type 2 for years, or the latest research showing that coffee is and isn’t good for you. Go figure, I say.

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